As lawmakers continue to debate the right path forward for meeting the health care needs of all Americans, there is one crucial aspect of the system that is consistently overlooked: the diagnosis and treatment of chronic pain. Though 100 million Americans suffer from this disease, the lack of information available within the medical community, and in some cases unwillingness to treat pain, is causing serious breakdowns in a system that is meant to protect patients, not harm them.
Our earnest attempts to solve two very complex problems has led us to seize on single, simplistic solutions that end up causing more harm than good. From my own experience with pain and in working first-hand with hundreds of pain sufferers, I have learned that there isn't a one-size-fits-all approach to chronic pain management. For most, the solution involves finding a combination of treatment modalities that together help reduce one's pain to tolerable levels. Treatments could include various types of medication, nerve blocks, physical therapy, biofeedback, exercise, acupuncture and many others.
Unfortunately, those who do rely on medication in whole or in part continue to face ongoing barriers due to government pursuit of a single-minded solution: cutting off the supply of prescription pain medication as the only means to solve the complex societal problem of abuse and misuse. For example, take the simple act of filling a prescription at the local pharmacy. While this is something many of us take for granted, pain sufferers often find their pharmacy either does not carry the medication or is not able to maintain a sufficient amount in stock to fill the need within the community. Even more discouraging is that many times these challenges are out of the control of even the pharmacists themselves.
According to a recent survey by the National Community Pharmacists Association (NCPA), legitimate pain patients, including seniors and those battling cancer and other painful conditions, are suffering due to uneven access to pain medications. The survey suggests a main reason could be the "perceived pressure, intimidation or a lack of clear guidance from law enforcement officials." According to Douglas Hoey, NCPA CEO, "Vulnerable patients are increasingly and tragically becoming collateral damage in the country's battle against the abuse of prescription drugs."
Prescription drug abuse is a serious problem in the U.S., and there is much more we can do to address and prevent it. Chronic pain is serious too, and prohibiting access to much-needed treatment is not the answer to either problem.
Chronic pain is America's biggest public health problem. It affects more people than heart disease, cancer, and diabetes combined. According to the Institute of Medicine, chronic pain costs the nation between $560 and $635 billion each year in direct health care costs and lost productivity. Though the burden of chronic pain on our citizens, our workforce, and our health care system is staggeringly high, it is still widely misunderstood and far too often overlooked. Even with proper access to medication, it is a serious health condition that sufferers must manage and struggle with every day. Effective medications and innovative, new treatment options for chronic pain should be encouraged and celebrated, not stifled.
The good news is that there are many proactive steps we can take to combat prescription drug abuse while protecting care for the millions of Americans living with chronic pain who take their medications safely and responsibly. Community-based drug safety programs and middle and high school curriculum on prescription medication abuse would better inform teens, parents and teachers about the dangers of abuse and misuse. A coordinated nationwide public awareness program on the importance of securing all medications in our homes would help ensure that medicines do not end up in the wrong hands.
We must also do a better job educating health care providers in professional schools and through continuing education on proper pain assessment and management and appropriate prescribing. Establishing permanent drug disposal locations around the country will help eliminate unused medication. Use of electronic prescription drug monitoring programs and encouraging further research into the development and use of abuse deterrent formulations will also help. Additionally, insurance and government reimbursement of a range of treatment options for managing pain discussed earlier could reduce the need for medication.
Moving forward, lawmakers, regulators, patients, clinicians, dispensers, researchers, industry and law enforcement must all work together to help shape the future of how our nation addresses both devastating diseases -- chronic pain and substance abuse. Only then will we truly be contributing to a healthier nation.
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